It is difficult to tell you exactly what your son’s chest pain means with little information. Therefore, I can only give you some general ideas about it. The vast majority of chest pain in pediatric and adolescent patients is non-cardiac in nature. It is more reassuring that it is sharp, although I do not know where exactly it is located, nor do I know how severe it is. It is common for adolescents to have brief, sharp chest wall pain that is mild to moderate in nature, typically worse with inspiration, not reproducible with pushing on the chest wall, and located anywhere on the chest. We do not know what causes this chest wall pain, but we do know that it is not due to the heart (or a heart attack), and that it does not cause any medical problems.
Chest pain with exercise can be because of muscle strains or tears, or can be associated with a true heart problem. The pain associated with a true cardiac reason, though, is the worst pain EVER. It is a crushing sensation in the middle of the chest, like an elephant sitting there, with radiation up to the neck, out to the left arm, or down to the abdomen. These people are sick appearing. The pain can last 20 to 30 minutes, and they can be very pale, sweaty, nauseated, and dizzy; it is not reproducible by pushing on the chest. As best as I can tell from your information, I do not believe that this is what is happening with your son. However, if he does have pain or discomfort such as what I just described, it would be important to have him evaluated urgently.
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